Healthcare Provider Details

I. General information

NPI: 1467843797
Provider Name (Legal Business Name): SUSAN REES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2015
Last Update Date: 02/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 ATWOOD DR CLINICAL & SUPPORT OPTIONS SUITE 301
NORTHAMPTON MA
01060-4272
US

IV. Provider business mailing address

8 ATWOOD DR CLINICAL & SUPPORT OPTIONS SUITE 301
NORTHAMPTON MA
01060-4272
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-8084
  • Fax:
Mailing address:
  • Phone: 413-584-8084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN257490
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: